Older people’s lived experiences of personalised care in care homes: a meta-ethnography

The UK has more than 400,000 people living in 17,000 care homes. The majority of these residents are older people living with dementia, frailty, and end of life care needs. UK Care Home guidance and policies advocate that all residents must have their preferences considered, and reasonably adjusted to meet the person’s specific needs. Research that considers residents experiences of the care they receive is limited. This meta-ethnography aimed to explore care home residents’ experiences of receiving personalised care. Six electronic databases (CINHAL, Medline (Ovid), Embase, PubMed, Web of Science & PsychInfo) were searched to identify qualitative studies that considered residents’ personal experiences of care in care homes. All studies needed to include resident voices (as data). Fifteen international studies published in the last 10 years met the inclusion criteria. These studies were reviewed and synthesised using eMERGe guidance. Four conceptual categories (the challenge of fitting into institutional care, the passing of time, holding onto a sense of self, and a desire to feel at home) and two key concepts (creating a culture of purposeful living and caring; and forming and maintaining meaningful & empowering relationships) were identified. A developed conceptual framework of understanding highlights the importance of residents’ being supported to maintain agency and autonomy in their care to preserve a sense of self and belonging. The voices shared in this review highlight the importance of care homes moving from a position of ‘doing for’ residents, to a person-centred position of ‘doing with’ residents.